Evidence map›Paper›PMID 41458411›Full record

ArticleFrontiers in public health2025

Central venous catheter care and the healthcare-environment interface: outcomes of a quality improvement initiative in a resource-constrained ICU.

Rehab H El-Sokkary, Essamedin M Negm, Fayrouz Abd ElNaser, Al Zahraa Mohammed Soliman, Amira Hamed Mohamed Afifi, Samar S A Morsi, Alaa O Abdel-Kareem, Afaf M Eladl, Mona H Ibrahim, Maha Abdeldayem and 1 more

Abstract read
In one paragraph

Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Rehab H El-SokkaryMedical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Essamedin M NegmAnesthesia, Intensive Care, Pain management Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Fayrouz Abd ElNaserClinical Pharmacist in Emergency Surgical ICU at Zagazig University Hospitals, Zagazig, Egypt.
Al Zahraa Mohammed SolimanPublic Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Amira Hamed Mohamed AfifiClinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Samar S A MorsiMedical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Alaa O Abdel-KareemMedical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Afaf M EladlPublic Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mona H IbrahimPublic Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Maha AbdeldayemPublic Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mai M MalekMedical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Central line-associated bloodstream infections (CLABSI) are major indicators of healthcare quality and patient safety, particularly in resource-constrained intensive care units (ICUs). Aim: This study aimed to evaluate a pre-post quality improvement (QI) initiative designed to optimize central venous catheter (CVC) insertion and maintenance, reducing CLABSI rates, and promoting more sustainable critical care practices in a university hospital ICU. Methodology: A one-year pre-post QI study (October 2022-September 2023) was conducted in an emergency surgical ICU of a university hospital in Egypt hospital. The study was structured according to the Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) framework and using sequential Plan-Do-Study-Act (PDSA) cycles. All eligible ICU patients needing CVCs were included. The intervention included: (1) standardizing CLABSI definitions and rate calculations, (2) introducing CVC insertion and maintenance checklists with daily audits, (3) targeted staff education and training, and (4) forming a multidisciplinary CLABSI working group for monitoring and feedback. Over 6 months, process improvements were implemented, followed by 3 months of impact measurement, including assessing CVC insertion/maintenance compliance, CLABSI rates, and device utilization ratio (DUR), with all data collected manually. Results: A total of 1,370 patients and 2,277 CVC days were observed. The CLABSI rate declined from 7.56 ± 2.26 to 6.97 ± 1.31 per 1,000 CVC days (-13.4%), and DUR decreased significantly from 2.21 ± 0.34 to 0.98 ± 0.19 ( Conclusion: This single-center study had a small sample size and short post-intervention follow-up, which may limit generalizability. Nonetheless, the initiative demonstrates that structured, low-cost QI interventions can improve compliance, reduce device use, and may support safer, more environmentally sustainable ICU care. Continuous monitoring and multicenter validation that integrate infection control with environmental stewardship are essential to sustain improvements and minimize the environmental footprint of critical care. Digital surveillance and ongoing training can improve real-time monitoring and scalability in healthcare systems.

Indexed as

Catheterization, Central VenousCatheter-Related InfectionsCentral Venous CathetersIntensive Care UnitsQuality ImprovementAdultEgyptFemaleHospitals, UniversityHumansMaleMiddle AgedbundleCLABSIcomplianceCVC maintenancequality improvementsustainability in healthcare

Identifiers

PMID41458411
PMCPMC12741089

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.